[PSMA-PET-MRI and radio-guided surgery in cervical lymphadenectomy]

A 75-year-old male patient with suspicious cervical lymph nodes in level IV on the left side is presented. The cervical mass was detected in PSMA-PET-MRI as part of a restaging examination conducted due to an increase of PSA levels in the context of the patient's known prostate cancer. We conducted a selective cervical level IV lymphadenectomy with the aid of a gamma probe subsequent to radiolabelling with ^99mTc-PSMA. Two visibly enlarged lymph nodes with high gamma probe signals could be extracted. Histopathological examination revealed lymph node metastases of the known prostate cancer. Using an adequate tracer radio-guided surgery helps to detect pathological lymph nodes in the head and neck region allowing for supraselective resection.